ArticleAJNR. American journal of neuroradiology2019
Focal Hypoperfusion in Acute Ischemic Stroke Perfusion CT: Clinical and Radiologic Predictors and Accuracy for Infarct Prediction.
Article in AJNR. American journal of neuroradiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Long-term outcome of endovascular thrombectomy in patients with acute ischemic stroke: a systematic review and meta-analysis.Journal of neurology · 2025Pooled it
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- Diagnostically competitive performance of a physiology-informed generative multi-task network for contrast-free CT perfusion.Frontiers in human neuroscience · 2026Article
- Moving From CT-First to MRI-First Paradigm in Acute Ischemic Stroke: Treatment Rates, Time Metrics, Safety, and Outcomes.Journal of stroke · 2025Article
- Focal Hypoperfusion on Baseline Perfusion-Weighted MRI and the Risk of Subsequent Cerebrovascular Events in Patients With TIA.Neurology · 2025Article
- Body fluid multiomics in 3PM-guided ischemic stroke management: health risk assessment, targeted protection against health-to-disease transition, and cost-effective personalized approach are envisaged.The EPMA journal · 2024Review
- Article
- Computed tomography perfusion imaging-guided intravenous thrombolysis in acute minor ischemic stroke.Frontiers in neurology · 2023Article
- Chronic cerebral hypoperfusion and blood-brain barrier disruption in uninjured brain areas of rhesus monkeys subjected to transient ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2022Article
- Effects of cerebral artery thrombectomy on efficacy, safety, cognitive function and peripheral blood Aβ, IL-6 and TNF-α levels in patients with acute cerebral infarction.American journal of translational research · 2021Article
- Study on Model Iterative Reconstruction Algorithm vs. Filter Back Projection Algorithm for Diagnosis of Acute Cerebral Infarction Using CT Images.Journal of healthcare engineering · 2021Article
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Authors and funding
7 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposePerfusion CT may improve the diagnostic performance of noncontrast CT in acute ischemic stroke. We assessed predictors of focal hypoperfusion in acute ischemic stroke and perfusion CT performance in predicting infarction on follow-up imaging. MATERIALS AND
methodsPatients from the Acute STroke Registry and Analysis of Lausanne data base with acute ischemic stroke and perfusion CT were included. Clinical and radiologic data were collected. We identified predictors of focal hypoperfusion using multivariate analyses.
resultsFrom the 2216 patients with perfusion CT, 38.2% had an acute ischemic lesion on NCCT and 73.3% had focal hypoperfusion on perfusion CT. After we analyzed 104 covariates, high-admission NIHSS, visual field defect, aphasia, hemineglect, sensory deficits, and impaired consciousness were positively associated with focal hypoperfusion. Negative associations were pure posterior circulation, lacunar strokes, and anticoagulation. After integrating radiologic variables into the multivariate analyses, we found that visual field defect, sensory deficits, hemineglect, early ischemic changes on NCCT, anterior circulation, cardioembolic etiology, and arterial occlusion were positively associated with focal hypoperfusion, whereas increasing onset-to-CT delay, chronic vascular lesions, and lacunar etiology showed negative association. Sensitivity, specificity, and positive and negative predictive values of focal hypoperfusion on perfusion CT for infarct detection on follow-up MR imaging were 66.5%, 79.4%, 96.2%, and 22.8%, respectively, with an overall accuracy of 76.8%.
conclusionsCompared with NCCT, perfusion CT doubles the sensitivity in detecting acute ischemic stroke. Focal hypoperfusion is independently predicted by stroke severity, cortical clinical deficits, nonlacunar supratentorial strokes, and shorter onset-to-imaging delays. A high proportion of patients with focal hypoperfusion developed infarction on subsequent imaging, as did some patients without focal hypoperfusion, indicating the complementarity of perfusion CT and MR imaging in acute ischemic stroke.
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